Wednesday, November 23, 2016

eHealth Medical Fiction - "Cell" by Robin Cook

I just finished a page turner by Robin Cook called "Cell". I knew from the beginning that it was an eHealth type of medical fiction. It features a smartphone app called iDoc that promises almost to take over the role of the personal physician. I suspected while reading the influence by Eric Topol, who must be one of the greatest champions for spearheading the medical smartphone revolution.

I was not too surprised to find that Robin Cook does acknowledge Topol at the end of the book. For a while I was concurrently reading Topols' "The Patient Will See You Now" and "Cell".  Robin Cook wrote "Cell" in 2014 and he credited Topols' "The Creative Destruction of Medicine".  Reading the medical fiction is  just a diversion. If you really want to learn about how the smartphone will revolutionize medicine - read Topol.

Medicare should be a major department for all Americans, just like Education and Defense. The author appears to argue like this in the book as he alludes often to the Affordable Care Act and Obamacare. The villain is a Health Insurance Company bent on making billions with the miracle app. The iDoc app is wonderful as the algorithms on the smartphone help to prevent illness and conditions. Health advice is immediate and always accessible.

Unfortunately, the app takes a turn for the worse and the "heuristics" start killing off patients in the alpha testing.  That involves what I think is the only science fiction element in the story - a nano-chip implanted in diabetes patients that is remote controlled by wireless radio signals releasing doses of insulin.  In real life the FDA has approved an "artificial pancreas" of sorts - a network of devices - that automagically monitors and controls blood sugar levels - it just doesn't work on the nano scale.

Just saw over at the Geek Doctor blogspot there is a guest blog by Seth Berkowitz, MD about  Apple’s CareKit and ResearchKit frameworks and the HealthKit API being used at BIDMC. Engaging patients in their health like that is a step towards a kind of iDoc.

Sunday, November 13, 2016

Musing on the Interaxon Muse Meditation Headband

"For this calibration, find a comfortable position and take a deep breath".

The computer brain interface world is getting interesting. The first time I heard about these types of MUSE brainwave sensing devices was an experiment where they trained people to move a cursor on a computer screen using their brain waves and a EEG headband. Maybe it was the MUSE - not sure. The next thing they did was have those same people change the colour of the floodlights on Niagara Falls and the CN Tower using their entrained brainwaves.

 I have seen more than several research projects now that have involved the Interaxon Muse headband - a device that self-directs users into a calm state of meditation by reading their brainwaves through an EEG headband and translating the data into a meditation tracking app. It may be just the start before EEG caps and gels and wire attachments are a thing of the past.

The McMaster university library recently started loaning out this device so instead of buying one (about $400) I have borrowed one for a week. Mind you, I have 35 years of meditation experience in a variety of schools and techniques and am not expecting a device like this to teach me anything. But after taking an 8 week online mindfulness course - just videos and online instructions - I believe that meditation can be taught through technology.

After downloading the app and fumbling around trying to fit it on my head - should have looked at the visuals in the instructions -  I learned how to sync my brainwaves using the app on the ipad. I tried a 3 minute meditation in the living room while the TV was on, a laptop was playing a video in the background and I was talking to my wife who was doing her yoga exercises. My brainwaves during those 3 minutes were in the noisy/active category. I had scored no calm points and I heard zero "birds". Hearing birds means that your brainwaves are staying in a calm meditative space. Seeing a graph of my brainwaves is actually very interesting but scoring points for meditating well and being asked if I want to share that on Facebook or Twitter is another thing. Tempting though to show all my friends on social media what a noisy mess my brainwaves are - No!

I was sort of impressed with the app interface and the instructions by the MUSE meditation guide. The next time I tried it I sat in my meditation room on my meditation cushion and zabuton. I extended the time to 7 minutes. I chose the default beach imagery with the sound of lapping waves and wind. If you hear the wind, it is actually the sound of your own brainwaves making noise. You are not watching your breath. I sat in the half lotus posture with my hands in my lap, a classic meditation posture I have practiced for years. The resulting graph of my brainwaves after 7 minutes indicated that I had no active or noisy points - 98% calm state of mind and about 100 birds. I could actually hear the birds in the background if I turned up the volume.  Here is a picture of my stats. In my last 20 minute sessions the batteries in the MUSE drained and I had to resume twice so the stats are all thrown off.

It is getting interesting but I spent the rest of the day thinking that I have been under surveillance with my brainwaves subjected to mechanical replication and analysis. This experience was not at all a natural process, in spite of the kind and soft voice of the human guide behind the algorithms on the app. My gurus had years and years of training and practice in meditation before they were allowed to teach.  I didn't let that get to me because I am fascinated with the technology.

The next sitting session I tried 20 minutes - about the amount of my usual meditation time these days. The result was 100% in the calm space, over 200 birds, and no "recoveries" or straying outside the calm zone with distracted thought or lapse of attention to mindfulness of breathing. And that was just a "normal" session for me.

I am really impressed with this device but I am sure that I don't need it having learned the art and science of meditation the traditional way - sitting at the feet of the masters, going on retreats, and practicing daily. My real question and concern is how will this device work with digital natives and those new to meditation?

We live in a world of secular ethics and this device does not come attached to any religious ideology. We all know by now that a mindfulness of breathing practice cuts across the sectarian world. Creating calm brain waves just requires the right guidance and intervention. Is total reliance on the MUSE soulless and alienating?  Not necessarily, though I would probably recommend an online mindfulness of meditation course called Palouse Mindfulness rather than the MUSE for a true beginner - especially ones who are remote from teachers and centres and can't afford the cost. One of the practices in one of the major schools of Tibetan Buddhism is Lam Rim. Lam Rim literally means "gradual path". The gradual path to meditative calm is the best way.

Here is one tip from my Zen teacher on meditation that will help anyone understand the nature of mind and meditation. Sitting across from me at a table the teacher gave me a piece of paper and a pencil. He asked me to draw a small line to count each time I had a thought. It became obvious to me that the page would quickly fill up with counts of scattered thoughts. After sitting in meditation practice, the number of counts becomes noticeably fewer. Where did all those thoughts go? It is just a state of being. As American wise man Joe Miller once said "You can get more stinkin’ from thinkin’ than you can from drinkin,’ but to feel is for real!  And I Mean Really Feel!”

Sunday, October 16, 2016

Korean Medical TV Dramas II

1. Romantic Doctor Teacher Kim, 2016낭만닥터 김사부

Surprising discovery today! Another medical drama starts next week! We will tune into it for sure. What a banner year for Korean medical dramas! This one promises to be less romantic and more realistic.  Yes! What follows is more info from dramabeans at this link: 낭만닥터 김사부

"Romantic Doctor Teacher Kim is about a brilliant medical genius who is also a bit of an eccentric crackpot. He is the first and only triple-board certified surgeon in Korea, meaning that he is an expert in three different specialties, when most doctors spend their whole lives devoted to mastering one. Originally, he was revered as the rising star of the nation’s top hospital, but due to a traumatic incident, he makes the decision to step down and work at a small rural clinic to help treat the ailments of the elderly and underprivileged. Despite not acting in a contemporary drama for 21 years, Han Seok-kyu says in a Naver V App interview that he believes he can imbue this character with the warmth and well-meaning heart of a doctor. He will act as a mentor to two younger doctors played by Yoo Yeon-seok and Seo Hyun-jin when they are assigned to come to his hospital.

Yoo Yeon-seok plays an ambitious go-getter with a cold but charismatic personality. His counterpart, Seo Hyun-jin, on the other hand, plays a more timid character who initially started her medical career because people would compliment her for working toward it. Together under Teacher Kim, they learn the true meaning of being a doctor and the joys of bringing healing to patients.

In the recently released first teaser, Han Seok-kyu walks down a darkened corridor while his voiceover says: “When you come to my neck of the woods, there’s only one rule. We must save our patients no matter what happens. Everything else can go to hell, but we must save them.” An angry-sounding Yoo Yeon-seok yells back, “Who are you, a washed up gangster? What’s your true identity, a gambling addict or an emergency department specialist?” Then we see a couple shots of the hospital, a car crash, and Han Seok-kyu showing off his mastery with a scalpel, giving it a little spin."

2. Doctors, 2016 (Hangul닥터스)

The actress Park, Shin-Hye (박신혜) featured in this one. She was very popular in Heirs, a Dramafever sponsored teen angst romance that began surprising filmed in California.  As expected the drama mostly focused on a romance but the medical context was very compelling. The doctors were neurosurgeons and almost everyone and his brother in this drama ended up with a tumour requiring brain surgery. The brain surgery scenes were very realistic I suppose, but I have never seen one in person.

Under the bright lights in the surgery we see patients live and die (most live) after various pieces of their grey matter are extracted in various states of urgency. Brain trepanation or whatever they do to open the skull is part of the action of course, but these smart doctors make it all look like a breeze.

The character Park, Shin-Hye played was a real rebellious street kid but had an IQ over 156. She was better at martial arts than homework until a series of events propelled her into a career objective to become a doctor. How the street smart street fighter became a doctor was all due to the powerful motivation of revenge - a very common theme in Korean dramas. Not sure why one version of the title for the series was Doctor Crush, but most Korean TV dramas have more than one translated English title, making searches on them for more information sometimes difficult.

3. Beautiful Mind, 2016 (뷰티풀 마인드)

By Source, Fair use,
On at the same time as Doctors, was it just a coincidence that this medical drama was also about neurosurgeons? Did the two different Korean TV networks intentionally set out to make a competition for the ratings with the same theme?  If so, this drama did not have the breezy romance and good nature of Doctors. It also did not have the ratings and ended 2 episodes earlier than it was supposed to. It had more of a biting edge to it, mostly in the form of the lead actor who played a neurosurgeon who had no common sense of human emotions - a kind of autism as a result of the brain surgery error by his adoptive father.

No more spoilers, but at any rate, one constantly asks - how can a doctor have no interpersonal skills (sort of like Dr. House but more extreme) because really he doesn't know how to relate to human emotions? Don't worry - it all works out - and true love once again saves the day. Of course there is a romance rolled into this drama as well.  Explaining the lower ratings to Doctors is kind of difficult to fathom in my books.

The lead actor Jang Hyuk is excellent, especially playing this sensitive and complex character. He was amazing as the YanBan (scholar class) turned slave hunter in Chuno (추노) , a highly rated TV drama series. The character he plays reminds me of a rare psychological condition where a person can't empathize at all with others. There are other rare conditions where persons don't even feel physical pain - many daily life dilemmas there. But acting the role of a doctor (whom one might expect to be the epitome of being able to be empathic) who does not feel empathy or any human emotions, is quite a challenging one. I still don't know why they gave it the title "Beautiful Mind", which is the same title of another movie staring Russel  Crowe who played the Nobel winning mathematician John Forbes Nash Jr.

We see a lot of scenes of X-rays up on viewing screens more than the bright lights of the surgery ward. We are also exposed to an endless stream of ethical dilemmas, including ones involving unethical clinical trials and fudging of the data. Couldn't ask for anything more educational than that. One yearns episode to episode to find out how or if this physician will discover his inner human heart and not be forever the automaton - or be found out by his colleagues for having this rare condition as it is secret.  There is a good vs. evil sub-plot to all of this which has a very good doctor (Lee Jae-Ryong) from the series General Hospital 2 playing the role this time as the very evil doctor (if you want to define evil as not just greed but wanting to save human lives at the expense of expendable human participants in drug research).

A sub-plot in the drama involves a lawyer who becomes a physician in order to become a better lawyer who persecutes physicians for medical malpractice - motivated of course because of the tragic death of her father due to medical negligence. Can she really balance these two different worlds at one time or can she decide that she sincerely wants to be a physician? Her fellow residents think she is pursuing a dangerous conflict of interest - and in fact she is.

4. Descendants of the Sun, (태양의 후예)2016

Nothing like a catchy OST to drive the popularity and run parallel to the heart tugging emotions that make up a series. This drama had very high ratings in Korea but it was a runaway smash hit in China with half the nations population tuning or something, and it came with government warnings that Korean dramas are sometimes not good for your health or social relationships. Taken with a grain of salt of course - and this was mostly a medical drama. The two Songs Song Joong-ki, Song Hye-kyo, are absolutely brilliant, and so are their buddies, who also have the other  great romance - Jin Goo, and Kim Ji-won,. Much talk now about a continuing series.

Well, the lead actress is an ER doctor and the main actor is a high ranking top secret soldier, but the plot is mostly based around medical dramas and  humanitarian situations, primarily in a war torn country where the Korean military has volunteered for a peace keeping mission.  The drama was partially filmed in Greece, and many characters are non-Koreans in the fictionalized country - very interesting scenes for a Korean TV drama, which are by large mono-cultural.  That has been changing because we have seen dramas where trans people and people with disabilities are leading characters (if not cast members).

The conflict or play off between Joo Won saving lives as a physician and taken them (in order to save lives) as a soldier, are as constant as the burgeoning and yet impossible romance that builds between the two leading characters. The medical scenes compliment the military actions - emergency response to earthquakes, terrorism, and ebola-like disease outbreaks. It is a humanitarian mission full of human compassion. You can also just sit back and enjoy the excellent OST and the humorous and sad romance between the other leading characters.

5. Yong-Pal,(용팔이) 2015

As I understand it the title of this drama is very similar or a play on words to the Korean expression for "quack doctor" -돌팔이 physician and 하다 or excellent or amazing.  The doctor in question is not yet a doctor - still a resident - but he is an exceptionally gifted surgeon and becomes a doctor to some shady underworld characters who always getting wounded in gang wars. He is making money to stitch them up in a black mailed kind of way but he needs it to pay for his sisters kidney dialysis and transplant. This was a recurrent theme in the 2016 medical TV dramas (Doctors & Beautiful Mind) - paying for medical bills by those who can't afford it -  while the corporate executives are trying to make a profit in healthcare. No doubt this is also the current reality of healthcare in Korea.

Another facet of the current reality of healthcare in Korea are the exceptionally gifted plastic surgeons. Thousands of medical tourists go to Korea for plastic surgery, some carrying the photos of Korean actresses (or actors) who they want to look like - and apparently that is what they come out looking like. There is a Korean word for these kinds of amazing physicians. So far I haven't seen a medical drama about plastic surgeons. God spare me please.

The romance in this drama involves Yong-pal and his ultra-rich patient, the daughter heiress of an incredible fortune who is being kept in a drug induced coma in a high tech life suspension facility in a secret room of the top floor of the hospital - also owned by the same rich family. Of course, the criminal intrigue for keeping her in a coma is the plot of her older brother who thinks he should inherit the corporation. She is really not sick - she is intentionally being kept in the coma. Apparently she can still hear what is going on around her.  Intriguingly, the scapel in the poster for the series is the "mes" 메스, a Korean loan word that becomes easily learned by watching these medical dramas. It will feature prominently in the Jejunwon drama which depicts the transformation of Korean medicine from the traditional to the modern during the Japanese occupation - the first surgeries to use the scapel in other words.

The lead actor in this drama, Joo Won was excellent in Bridal Mask (각시탈),  where he played a Korean who rose high in the ranks of the Japanese Police during the Japanese colonial period only to later betray the Japanese and become 각시탈, a Korean Robin Hood freedom fighter who wore a Korean bridal mask while fighting against the Japanese.

6. Doctor Stranger, (닥터 이방인) 2014

It is always good to see Korean dramas that involve many scenes taking place in North Korea because it suggests there is still hope for this nation of one people, one language and one culture to get together at long last.  Of course, the North Koreans are adversaries throughout this tense drama, which doesn't have so much the light and breezy romantic qualities of Doctors for example. Not much is memorable for me in this drama except for the strange intrigue of Korean politics between North and South. Of course, the doctor trained in North Korea (where human experimentation reigns supreme without ethics boards) is far superior to the doctors in the South. But how can he even practice in the South? Well, originally he came from South Korea before he and his Dad were kidnapped into the North intentionally but political baddies in the South - it is all so confusing, so don't ask me, better watch it yourself. As I recall there is a lot of tense drama to this, a quick moving plot, and the romance is not syrupy and sickly sweet. Did I ever tell you that there is nothing wrong with a 16 episode Korean TV drama. Anything under that is not going to be as good.

7. Good Doctor굿 닥터 2013

This drama was going to be painful to watch at first because the lead doctor is an "autistic savant" who has incredible memory and genius but can't tie shoes and fumbles counting pocket change. Would you put a scalpel in that man's hands? Anyway, the lead actor is the very talented Joo Won , who is quite adept are playing these sensitive roles - and playing physicians again. Apparently though, being vulnerable and simple this way will get you the girl. His naivete and innocence are appropriate for his role a pediatric surgeon because he relates so well to kids on that level.

All Korean medical dramas have competition between various departments and lots of jealous intrigue between the competing physicians, their superiors and their understudies. Most have competitions and intrigues for the top dog position in the hospital pitting a white knight against a black knight. Some really useful Korean to learn which will give you an insight into the nature of Korean social relationships is the senior - junior demarcation.  A senior to you in either age, year in school, or rank in employment is your "sunbae" (선배) or "junior" (). The subtitle translations on Dramafever or Viki won't always get this. They will translate with the name of the person being addressed when in reality the person is being called "Sunbae" instead of their name. Koreans all live in one vast extended family and the way they address each other according to age and rank is fascinating. It is also very important for how they speak to each other using formal or informal grammar, tone, and manners.

8. Hur Jun: The Original Story, 구암 허준 2013

By Source (WP:NFCC#4), Fair use,

I really admired this remake of the Heo Jun series from 1999. (There was actually an early version from the 1980s which I never saw). The legendary Joseon dynasty doctor reminds me of Shakespeare. They both lived at almost the same time - end of the 16th century. Not much is known about the personal lives of either. Both left works of massive masterpieces in their field which influenced the lives of millions for all posterity.  This 2013 version is very faithful to the 1999 version which was so masterful to begin with. That to me was the most surprising. After the radical departure from the 1999 version at the very beginning, for a while later I thought they were doing a scene by scene remake but just with different characters.  It was infinitely more subtle than that. Could it even be improved? That they even tried to do better is so laudable and many times I think they did succeed. Well, I thought it was almost better than the 1999 version did but there is a difference of opinion in the Korean family here that the 1999 version is better. It reminds of Harvey Cushing's biography of the great Canadian physician William Osler, which some writers have called a "hagiography" or the biography of a Saint. Hur Jun is a Korean saint - no doubt about it in my mind - the Dongui Bogam forever. Never watched a Korean drama with 50 or more episodes? 

9. Sign, 싸인 2011

Sign is not to be confused with the spellbinding detective mystery from 2016 called Signal.  Sign is a lesser drama and that might have to do with the fact that it is about the life of forensic doctors. One would think with the popularity of CIS and American dramas like that that the Koreans could pull off a good one too. Sign is very good, in spite of the weak plot lines which are almost unbearable at times. However, the attempt to show forensic science by referencing the very real NFS - the National Forensic Service of Korea - succeeded, I think, in making the doings and goings on of this profession better known to the public. It is always the general public who are are always the dupes in Korean dramas, from Joseon dynasty dramas all the way to the present day. There are always the rich and powerful playing the puppet strings of everyone else.

10. Jejunwon제중원, 2010

By Source (WP:NFCC#4), Fair use,
Having taught English in Korea for almost four years, as a teacher in the public education system I was indoctrinated to the cultural history of Korea and the atrocities inflicted on the Korean people during the Japanese colonial period.  Make no mistake - that time in the history of Korea - even before the Korean war - was no joke. This drama is poignant in the context for those times, beginning when the last King of the Joeson dynasty ruled, to the Japanese colonial takeover. Parallel to those historic events we have the unfolding of the medical drama where the Korean people transition from practicing traditional or Chinese medicine to the techniques of modern surgery.  A white missionary who was also a doctor and actual historical figure appears in this drama. This drama is in fact based around a lot of historical characters and events, who often appear in scenes, if not whole episodes. For today, the Jejunwon, that held the first beginnings of the modern Korean hospital, lives on as the Severence Hospital, itself associated with one of the best Universities in Korea - Yonsei University.

In this drama the first and best of the Korean surgeons turns out to be the poor son of a butcher and himself a butcher, the lowest undesirable class in the later Joseon.  The drama is about how he becomes the first and the best scalpel wielding doctor in Korea, better than an aristocratic Korean who went to Japan to learn modern surgical techniques. It is a class war struggle where heart and brains win out over class and privilege and where later class and privilege win heart and brains. It's also a drama about loyalty and fierce patriotism to the Korean people.

11. General Hospital 2, 종합병원 2008

This drama was hilarious and it reminded me of my favourite TV medical dramas when I was kid in the 1960's, especially the superb UK "Is there a doctor in the House".  However it was not nearly as bombastic, darkly humorous, absurd or slapstick hilarious. In fact, it was very heart warming and serious whilst playing off the comical residents with the seriousness of actual medical cases. The leading actor Cha Tae Hyun is a gifted comic actor and he was able to blend the seriousness of being a resident in the surgery department with character of a comedian. (Cha Tae-Hyun is also superb in a film I heartily recommend called "My Sassy Girl", even if you only watch the first 8 minutes).

The lead character is a resident who has to learn care for patients, exercise a good bed side manner, and not feel defeated when errors are made.  Though not the brightest of the residents in training and did not attend the best school (Koreans are really cliquish and snobbish about school rankings), he did have the most human compassion for others - a trait recognized by only the best of his superiors. Many actors with the exception I think of Cha Tae Hyun were returning from the first version of General Hospital almost a decade earlier. In the first series Lee Jae-Ryong was like Cha Tae Hyun, a first year resident just trying to survive the militaristic orders of her overseers. In the second series which is over a decade later in real time, Jae-Ryong becomes Tae Hyun's supervisor. This is a genuinely funny, warm and compassionate TV medical drama.

This post is dedicated to Dramafever and Viki, Korean TV drama and movie hosting sites that have provided us with truly awesome entertainment for the past several years. I would also like to make another shout out to Google chromecast, for helping to liberate us from Cable TV, and for being integrated into both the Dramafever and the Viki app. Subscribing to Dramafever or Viki is much cheaper than Netflix and you will never see another ad again.

Tuesday, September 27, 2016

Korean Medical TV Dramas

In 1999 I was teaching English in Korea and I used to rush home after work to try and catch the next cliff hanging episode of Heo Jun. This Korean medical TV series was the dramatization of the well-known and loved 16th century Korean physician Heo Jun.

"Heo Jun (허준, 1537?/1539 – 9 October 1615) was a court physician of the Yangcheon Heo clan during the reign of King Seonjo of the Joseon Dynasty in Korea.[1] He was appointed as a court physician at the age of 29. He wrote a number of medical texts, but his most significant achievement is Dongui Bogam (lit. "Mirror of Eastern Medicine"), which is often noted as the defining text of traditional Korean medicine. The work spread to East Asian countries like China, Japan, and Vietnam where it is still regarded as one of the classics of Oriental medicine today. Although Heo Jun worked extensively with the royal family, he put a great emphasis on making treatment methods accessible and comprehensible to common people. He found natural herb remedies that were easily attainable by commoners in Korea. Furthermore, he wrote the names of the herbs using the simple hangul letters instead of using more difficult hanja (Chinese characters), which most commoners did not understand.[2][3]"

At that time there were no English subtitles and I had to ask my Korean family for a running translation. There were no English TV channels and I lived in a county in the middle of Korea where few people spoke English. I was spending more time learning Korean than teaching English just so I could communicate and get around. Even with my family's limited English ability, I was still entranced and riveted to each episode. And each episode ended with a cliff-hanger and the suspense for the next week's episode was contagious. I did literally run home so I could catch at least the opening theme music, which was in itself very catchy. It wasn't until 6 years later that I was able to see the drama again with English translation. In 2013 they did an excellent remake.

In 2005 we were able to rent VHS tapes from a local Korean grocery store in Canada where we now live of a Korean drama called Dae Jang Geum. This drama was a huge international hit and all time classic. Dae Jang Geum is sometimes translated as "Jewel in the Palace". Dae Jang Geum doesn't start out as a medical drama though there are a few scenes with illustrations of Traditional Korean medical practices. It starts out as an intrigue in the royal palace and then develops more of a theme focused on palace cooking and palace politics and customs. The theme later dives very deeply into Korean Traditional Medicine and how Dae Jang Geum learned the art and science in order to return from exile and enter palace life again, but this time as a physician. The palace cooking stuff continues and it is great. Who doesn't love Korean food?

This VHS series also did not have English translations so I had to rely on translations from family and my own interpretation of the actions. If I had spent over $300 I could have ordered English translated CDs. Eventually I was able to watch the drama for the first time on Youtube, in short 10 minute clips that had passable translation. Even with my limited Korean it was obvious many translations were wrong. It was a great revelation to finally be able to see the English subtitles though, and not too long ago, I re-watched it in hour long episodes with good translation. Tragedy, romance, comedy, politics, history, culture, Traditional Korean Medicine - it has it all.

"Dae Jang Geum (Hangul: 대장금; hanja: 大長今; RR: Dae Jang-geum; MR: Tae Chang-gǔm; literally "The Great Jang-geum"), also known as Jewel in the Palace, is a 2003 Korean television series directed by Lee Byung-hoon. It first aired from September 15, 2003 to March 23, 2004 on MBC, where it was the top program with an average viewership rating of 46.3% and a peak of 57.8% (making it the 10th highest rated Korean drama of all time). Produced for US$15 million, it was later exported to 91 countries and has earned US$103.4 million worldwide, becoming known as one of the primary proponents of the Korean Wave by heightening the popularity of Korean pop culture abroad.[1][2][3]

Starring Lee Young-ae in the title role, it tells the tale of an orphaned kitchen cook who went on to become the king's first female physician. In a time when women held little influence in society, young apprentice cook Jang-geum strives to learn the secrets of Korean cooking and medicine in order to cure the King of his various ailments. It is based on the true story of Jang-geum, the first female royal physician of the Joseon Dynasty. The main themes are her perseverance and the portrayal of traditional Korean culture, including Korean royal court cuisine and traditional medicine.[4]"

Now that I have seen more Korean dramas that just have medical or hospital themes I am also interested in ratings and what are the best ones. Of course, what is best is subjective and ratings don't necessarily reflect what one might personally enjoy. I find that a lot of ratings are on Wikipedia. Hur Jun and Dae Jang Geum are in the top ten all time rated Korean dramas, and that is not just drama that involve a lot of Traditional Korean medicine. I remember signing a petition to ask the BBC to play Dae Jang Geum drama for British TV audiences. I don't think it was ever successful, but the drama did play successfully around most of known universe.

An important note to make about Heo Jun and Dae Jang Geum is that they were both directed by Lee Byung-Hoon, who is still going strong making these epic 50 plus episode period dramas based in the Joeson Dynasty history or saeguk. I think they are superb representations of the Korean people and culture - even if only part fantasy and dramatization - there is so much to speak for them.

It seems like it was about 4 years ago that we started watching a lot of Korean TV dramas on our laptop computers utilizing the streaming services of a variety of Asian and Korean drama websites. A lot of these had dubious video and sub-title quality and came with annoying ads. Eventually services like Dramafever and Viki would become the best in quality and we subscribed monthly for a very low subscription rate. A few years ago we cut the TV cable and bought a Chromecast device so we can stream Dramafever and Viki to our big screen TV. The age of binge Korean TV drama had finally arrived.

Here is a list of Korean TV dramas that have a medical theme, plot or drama (In fact if you google "Korean TV medical drama" you will get several lists but these are just the ones that we watched). I must say that 2016 has been an awesome year for good medical dramas from the Koreans.

1. Doctors, 2016
2. Descendants of the Sun, 2016
3. Beautiful Mind, 2016
4. Yong-Pal, 2015
5. Doctor Stranger, 2014
6. Good Doctor, 2013
7. Hur Jun: The Original Story, 2013
8. Sign, 2011
9. Jejunwon, 2010
10. General Hospital 2, 2008

Why is the Korean word for scalpel "mes" 메스? Is that konglish ( Korean-English ) or is a real Korean word? According to Asianwiki it is actually a Dutch word! "Early Korean title was "Green Mes," which translates literally to "Green Scalpel". The word "Mes" is derived from the Dutch language and used in Korea/Japan to refer to a "scalpel". Title was then changed by KBS2 staff to "Good Doctor" due to some people's unfamiliarity with the word "Mes"." There is some very interesting stuff going on with these dramas and I think I will leave that to another post.

Thursday, September 15, 2016

Wednesday, September 14, 2016

Medical smartphone apps need research and evaluation

So I finally did start reading a book by Eric Topol - The Patient Will See You Now: The Future of Medicine is in Your Hands - and this book is an eHealth classic! So much of the focus is on how the smartphone is becoming the major medical instrument of choice, it often makes me think that the smartphone for medical applications is already the TriCorder. Smartphones with visual heart rate monitors are replacing stethoscopes for first year medical students! Seeing the heart is better than hearing the heart?

From a health informatics perspective it really made me think that we need research and evaluation on all the apps that are being used for medical purposes. Just looking around the WWW a little and indeed there are organizations and research about this:

Sunday, July 31, 2016

Eric Topols's NIH grant for Precision Medicine & Health Informatics Research

I have tried to read Eric Topol's classic books on digital medicine:  "The Patient Will See You Now: The Future of Medicine is in Your Hands" and the "Creative Destruction of Medicine: How the Digital Revolution Will Create Better Healthcare" but my local libraries don't seem to carry them. Not in the habit of buying every book I want to read on Amazon. I think Dr. Topol was a keynote at a nearby eHealth conference not long ago. Instead of attending, I subscribed to his Twitter feed which is well worth a look if you are not already inundated with more information feeds than a human could possibly digest in one lifetime.

The biggest news to come from Dr. Topol I may have first read in the San Diego Union Tribune, a news source I normally would never dream of reading, but for various disparate reasons (or algorithms) came to my attention from sundry WWW news sources. In fact I probably first read about it on the good doctors' Twitter posts.  Here is the link to the San Diego article, but it soon became apparent that the RSS was broadly distributed internationally. The Scripps Translational Research Institute, where Professor Topol works, just happens to be in San Diego:

The NIH doesn't often dole out $120 million grants for research. The last I heard of a grant with that largess was for research on the artificial brain, and I even blogged about that.  What I have not blogged about is precision medicine, which is defined well in this NIH Medline Plus article.  I am kind of wondering if precision medicine is just a plain English way of saying translational bioinformatics and health informatics all rolled into one.

This research project, that involves tapping into the blood samples, DNA, social media, health apps, sensor data, Big Data analytics and health records of a million volunteers, reminds me of  The Canadian Longitudinal Study on Aging. It certainly does bring to mind a classic in health informatics and epidemiologial research - The Framingham Heart Study of 1948 - which is still providing data for researchers. One can only imagine how the data generated from this research will be analyzed sixty years from now. Artificial Intelligence tools like IBM Watson and Alpha Go, which will probably be employed to help the data scientists, are just in the teething stage, compared to what their exponential computer grandchildren will be able to byte off.